Thank you very much for inviting me. A particular thanks to the member for Manchester Central, Lucy Powell, for inviting me here today, and for continuing to keep the political focus on school readiness in Greater Manchester. I am truly delighted to see such a range of early years professionals here today, and I would like to personally thank you for the hard work that you do. I know that all of you – whatever your role – share my passion and enthusiasm for ensuring our children get the best start in life.

School readiness is hugely important, and that is why the Department for Education has such a focus on the early years, and on improving communication and language skills in particular.

This is something that is very personal to me. Some of you may know that, at the age of nine when I came to this country from Baghdad, I couldn’t speak English, and I used to sit at the back of the classroom so the teachers didn’t ask me to speak in class. Sometimes when I got a bit more confident I tried to bring a few sentences together. My teachers thought I had learning difficulties. I now stand before you as MP for Shakespeare! But I had great parents and some great role models, and I learned English and then learned that being able to express yourself is the gateway to success, not just in school but in later life.

It’s these crucial early years that make the most impact on a child’s future path – because for those children who start out behind their peers, it’s so much harder to catch up. All the evidence tells us that we need to improve children’s communication and language before they arrive at school, to get them on track to be confident, able learners.

The Education Secretary has set a challenging ambition to halve the proportion of children leaving reception without the communication, language and literacy skills they need to thrive, over the next ten years. If we are to meet this ambition, we need to find new and creative ways of supporting children and families – as well as our workforce.

Greater Manchester is leading the way, and I am delighted to be here to talk about how we can work together to design and deliver systems both locally and nationally that can hopefully ensure every child is able to thrive when they start school.

I strongly believe that a key role for us in central Government is to support local leaders and professionals to innovate; and for Government to ensure the best ideas are able to flourish. The Children’s Social Care Innovation Programme has been a successful example of that approach. And our £6.5m Early Outcomes Fund draws on those lessons to help local authorities improve how they deliver services to improve early language outcomes. We will announce the outcome of that fund very shortly.

Today I want to highlight some further examples of where local innovation and central policymaking are coming together to drive progress towards our shared ambition. These broadly cover three areas.   The first of these is to address the work of the wider professionals involved in a child’s life.

This ranges from GPs, health visitors, speech, language and communication therapists and many more. Health visitors play a particularly important role in identifying and supporting children with speech, language and communication needs.

That is why my Department – in partnership with Public Health England – will train 1,000 health visitors. Wave 1 will begin shortly in areas of high need, including Oldham and Tameside.

This is an area where Greater Manchester is really blazing a trail – both through your language pathway and your investment in tools to identify speech, language and communication needs early. Together these are designed to support the local workforce to identify speech, language and communication needs as early as possible and put in place support that is needed.

Again, this is an important example of how Government can take innovative practice and take it to scale. My Department – again in partnership with Public Health England – is developing a new bespoke early language assessment tool, under government copyright, that will be made available to health visitors and professionals across a wide range of local authorities in need.

Today, I am pleased to announce that the University of Newcastle, led by James Law – Professor of Speech and Language Science – will develop our early language assessment tool. The team working on this tool has extensive expertise in speech and language therapy, health visiting and general practice, and academic expertise in linguistics, psychology and statistics.

We are also working with Public Health England to publish early language pathway guidance which will support local areas to develop and implement their own pathway – similar to that which you have done in Greater Manchester. You have really been the pioneers of this.

Of course, the most important people in a child’s life are their parents. Which brings me onto the second area I want to talk about – improving the Home Learning Environment. Because the evidence is clear that what happens at home in the early years is absolutely key to outcomes later in life.

That is why, in November, the Department held a summit, at which we brought together a coalition of over 120 businesses, voluntary groups, community and public sector organisations. These organisations all share a common goal – to help parents kick start their child’s early communication, language and literacy development at home.

We want to get across that there are really simple, everyday things that every parent can do more of to help their children’s language and literacy.

Since the summit, I have been working with some of these organisations to bring their commitments to life, and it is no surprise to me to find that there is some excellent, innovative practice here in Manchester. Today after this summit, I am visiting Manchester City Football Club, to observe one of their sessions that uses physical activity to enhance children’s communication and language.

Our next steps are to launch a public campaign to encourage parents to chat, play and read more with their children. I recognise that it is important to get this message out there in local communities if we want to see a change in parental behaviour, and for this to work, I will really need your help and expertise.

Our public, private and voluntary sectors are all a vital part of this coalition. From early years settings to libraries, from health visitors to local employers, everyone has an important role to play as part of this society-wide mission to improve the home learning environment.

One of the most important contributions comes, of course, from early years professionals. And this brings me onto the third and final area I want to talk about today – which is supporting the work of our early years settings. I am always struck by the passion and commitment that I see first-hand when I visit early years settings up and down the country. I want to be able to support you to do your job as best as I can.

I know this is a key focus for Greater Manchester. It is for me too. My department’s Workforce Strategy, published in March 2017, has resulted in a number of developments to support the early years sector in recruiting, retaining and developing its workforce. These include publishing new level 2 qualification criteria, and a new early years career progression map – both developed through work with sector stakeholders.

I am also delighted to hear that you are encouraging and supporting the use of apprenticeships for your early years workforce. For employers, developing well trained and highly motivated staff who work to the standards they expect is hugely valuable. I am an enthusiastic supporter of apprenticeships and the grow-your-own ethos of the sector.

I also want to address the importance of continued professional development, which I know is another key focus for Greater Manchester. This is why my Department – in partnership with the Education Endowment Foundation – is investing £5 million to fund and evaluate projects focused on high quality professional development and practice in the early years.

And I recently announced a £20m Early Years Professional Development Fund, to help practitioners improve children’s early language, literacy and numeracy. This will be delivered via a ‘train the trainer’ model – much like your planned workforce academy. We recently tendered for a national training partner and are currently assessing the bids. I hope to be in a position to announce the preferred bidder shortly.

Now there is one small but important group of early years settings that I want to mention in particular – Maintained Nursery Schools.

The supplementary funding that my Department provides local authorities to enable them to protect Maintained Nursery School funding and reflect their higher costs is due to end by March 2020. What happens after that will be determined by the Spending Review. But the Spending Review has not yet happened, and this has created an unusual problem for local authorities and Maintained Nursery Schools.

Rightly, you want to allocate places in Maintained Nursery Schools for this September in good faith, but without knowing whether the summer term of 2020 will be fully funded.

Today I can reassure you that you can indeed offer places in good faith. We will provide local authorities with a further £24 million for their Maintained Nursery Schools, to enable them to continue funding them at a higher rate for the whole of the 2020-21 academic year.

This should remove the immediate concerns about Maintained Nursery Schools. I know that this does not answer the question about their long-term future. But I think this is a pragmatic response – I hope you’ll agree – that recognises the excellent work that many Maintained Nursery Schools do. And it allows the Spending Review to determine the longer-term future of Maintained Nursery Schools, alongside wider early years considerations.   I have set out this morning some examples of the relationship between central government and local leaders and professionals working at its best, taking innovations to scale. In short, if we are to improve outcomes for disadvantaged children, we must think about how we can do things differently – including through parents.

No parent has all the answers – so we need to make it easier for them to kickstart their child’s learning at the earliest opportunity, whether by encouraging them to take part in educational activities as a family, support from trained experts at home to identify concerns earlier, or better access to high-quality early years education.” I look forward to working together to give all children the best chance to flourish at school and in later life.

Thank you.

Student police officers working on the frontline will be able to apply for Taser training, the Home Office has announced today.

It comes after senior officers made a request to the department to allow selected students to put themselves forward for the specialist training. Previously, only officers who had passed their two-year probation period were eligible.

Student officers can be deployed to the frontline and face the same threats as ranked officers. Police chiefs therefore want certain recruits to complete Taser training where there is a clear local need.

Home Secretary Sajid Javid said:

The police put themselves in harm’s way to keep us all safe and that includes student officers working on the frontline.

Tasers give them an important tactical option when facing potentially dangerous and violent situations.

I remain committed to giving officers the tools they need to protect themselves, their colleagues and the public.

Lucy D’Orsi, National Police Chiefs’ Council Lead for Less Lethal Weapons and Deputy Assistant Commissioner, said:

Giving chief constables the option of selecting and training their probationary officers to carry Taser is a welcome step

Probationers are posted to the frontline and they respond to the same calls as other colleagues. These calls range from dealing with vulnerable people in need of help to incidents of serious violence.

At present, an officer’s suitability to carry Taser is determined by the amount of time someone has been an officer. The diversity of our workforce has changed considerably and many of our probationers have professional and life skills from before they started their police career that help to demonstrate their capability to carry Taser. I believe these skills should be recognised as well as their ability as a Police Officer, particularly when dealing with conflict.

Police use of Taser is regulated by strict standards and is conditional on the completion of a training programme.

All officers who volunteer to carry a Taser are required to have the support of their supervisor, endorsement at Superintendent level and pass the Taser training course.

In addition, student officers who undertake the training are required to:

• have been assessed as safe and lawful for independent patrol

• have demonstrated experience of successfully managing conflict

• hold a review with a supervisor following use of a Taser

The deployment of Taser is an operational matter for chief officers, who determine the number of devices and specially trained officers they need based on their force’s strategic assessment of threat and risk.

Taser refers to TASER®, the brand name of the conducted energy device used by police forces in England and Wales

It is a such a pleasure to mark Rare Disease Day with you all.

And I want to start by saying thank you to Genetic Alliance, Rare Disease UK and all of you whether you are patients, carers, researchers, clinicians or campaigners – it is down to you that we have come so far in recent years with rare diseases research and care.

We all know that:

• for too long too many parents had to cope with a sick child with a rare disease but with little information as to what the disease is, let alone where they might find treatment

• for too long GPs were frustrated by being unsure where the best centre of expertise is to treat a particular rare disease

• for too long the treatment of those with a rare disease was been seen as a public policy afterthought rather than as a priority

And this is why the establishment of the National Rare Disease Policy Board and Forum was a genuine turning point I think. It sent out a strong message to the whole system that information, diagnosis and treatment of those with a rare disease is not only now at the heart of the policy machine but it was also much more strategic and being developed with patients as its guide.

My own experience as an Ehlers Danlos patient has been entirely typical I think and has led me to my own conclusions about rare diseases policy.

I was undiagnosed for 30 years and went through all the usual experiences of the diagnostic odyssey – getting very sick from childhood and being referred to many doctors who each tried their best, ordering more and more complicated and invasive tests but ended up suggesting a psychiatrist or prescribing me something that just made me sicker.

Finally, a wonderful neurologist with experience of EDS realised what had been going on and referred me to a specialist who diagnosed me in 20 minutes. Twenty minutes – after all those years.

Over the next 18 months I acquired a fleet of specialists. Initially it was a disaster. As they started trying to find the right medical regime for me I got much, much sicker and I found trying to co-ordinate all the tests and appointments and new medications – while still working – impossible.

I do not think there is a flat surface in this building I have not collapsed on – including on this very podium where I tried to give speech a couple of years ago.

Then the NHS stepped in and saved me. The occupational therapist here in Parliament, my GP and the whole team at UCL Autonomic Unit literally picked me up and held my hand – helping co-ordinate my care and getting me the support I needed at work. Gradually, the pieces fell into place and I have clawed my way back to stable health. I will not pretend to any of you it was easy. It was not. And there were many setbacks along the way. But I do know I am incredibly lucky.

Firstly, my battles are nothing compared to many of you here today and for that you have my unending admiration.

Secondly, without my family I simply would not have made it. They have sacrificed beyond measure to care for me and I can never repay them.

Thirdly, I owe so many NHS workers – nurses, doctors, my GP, pharmacist, paramedics and more – my stable health today. I am not sure I will ever be able to communicate to them quite how dramatically they have changed my life.

But this process has also taught me indelible lessons about how urgent it is to improve care for rare diseases for everyone – not just the lucky ones like me.

This is why we must never relent in our campaign to bring an end to the diagnostic odyssey – it is pernicious and even after diagnosis the damage it does to mental health of patients and their families must not be forgotten.

We must press even harder on clinical awareness and groundbreaking research so more patients can be diagnosed and treated earlier.

Finally, co-ordinating your care can feel almost impossible when you are ill and the complexity of services for rare disease must not act as a barrier to access for care.

That is why the publication of the UK Strategy for Rare Diseases in 2013 represented such a significant achievement for everyone here today.

It put the emphasis firmly on raising awareness, improving diagnosis, and enhancing research and patient care and we have come a long way.

Today DHSC and NHS England have made good on the promise to publish annual updates to the implementation plan.

One year on we can celebrate some incredible milestones – let me just highlight a few.

Care co-ordination

Firstly, on the issue of care co-ordination I have asked NHS England to implement a rare disease ‘insert’ from April 2019. This refers to a set of provider criteria to sit alongside NHS England specifications for services treating patients with rare diseases and allows NHS England to hold providers to account for the way in which they treat patients with rare diseases.

There will be up to 3 criteria (depending on the nature of the service):

1. ensure there is a person responsible for co-ordinating the care of any patients with rare diseases
2. give every patient with a rare disease an ‘alert card’, including information about their condition, treatment regime and contact details for the individual expert involved in their care
3. ensure that every paediatric patient has an active transition to an appropriate adult service, even if that adult service is not the commissioning responsibility of NHS England

I hope that this will make a real difference for patients on the ground. I will be keeping a close eye on whether it does.

Research

Many of you will know that the National Institute for Health Research (NIHR) has established the new BioResource for Translational Research for Common and Rare Diseases.

By March 2018, 37 individual rare diseases had been adopted and by 2022 we expect this number to have increased to 100.

The in-depth phenotyping for rare diseases, linking that to genomic data promises to provide an invaluable research environment for rare diseases discovery.

At Public Health England the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) has made brilliant progress expanding their registries this year.

They have achieved 100% population coverage for conditions diagnosed either antenatally or postnatally, up from 49% in 2017 to 2018.

I truly believe this will improve our understanding of the causes, diagnosis and treatment of rare diseases.

I would like to thank everyone in this room who has played a part in developing these vital research projects.

EU Exit and European Reference Networks

I know though that many here are concerned about the potential impact of Brexit on our research capabilities. I want to stress the government is a strong supporter of the European Reference Networks (ERNs).

We are keen to agree a future relationship with the EU that includes continued participation in the ERNs.

We have made this position clear to the European Commission.

In return, the European Commission have shown that they recognise the significant expertise of UK clinicians. Both sides appreciate the importance of maintaining UK participation.

Refresh of the UK Strategy for Rare Diseases

As we work hard on what our future relationship with the EU will look like, I am also aware that we need to work hard on what the future of the UK Strategy for Rare Diseases post 2020 will look like.

I can reassure you that, post 2020, there will be an overarching framework to improve the lives of all those living with rare conditions. I am sure you will appreciate that it is too early to know exactly what this would look like, but I am personally committed to ensure that the rare disease community are closely involved as we move forward on this.

Genomics

The really big news, of course, is that in December 2018, the 100,000 Genomes Project completed its sequencing phase – a fantastic achievement by NHS England, Genomics England and other partners including Health Education England.

I know that this project has delivered life-changing results for patients – 1 in 4 participants with rare diseases are receiving a diagnosis for the first time – but it wouldn’t have happened at all without the support and participation of many of you here today so I want to personally thank you for the historic role you have played in helping us transform life chances for so many others with rare diseases.

Not only that, but this project has paved the way for using genomics in ‘everyday’ healthcare.

Last year, NHS England launched the Genomics Medicines Service (GMS), making the UK the first in the world to integrate genomic technologies, including whole genome sequencing, into routine clinical care.

As the NHS Long Term Plan in January, seriously ill children who are likely to have a rare genetic disorder, children with cancer, and adults suffering from certain rare conditions or specific cancers, will all be offered whole genome sequencing from 2019 under the new Genomics Medicines Service.

This all speaks to a wider ambition.

We want to lead the world in the use of data and technology to prevent illness, not just treat it.

We want to diagnose conditions before symptoms occur.

And we want to deliver personalised treatment, informed not just by our general understanding of disease but by our own personal, de-identified medical data – including our genetic make-up.

Now you will know that the NHS Long Term Plan outlines our vision for the NHS over the next 10 years.

The plan focuses on prevention and early detection and has been developed with frontline staff, patients and their families.

The plan also sets out the ambition to focus targeted investment in areas of innovation, particularly genomics.

This will enable more comprehensive and precise diagnosis, and allow patients to access more targeted treatments to reduce the use of harmful medications and interventions.

In order to make this a reality, I am delighted to announce that we will be working with the National Genomics Board, people in this room and the broader genomics community to develop a National Genomic Healthcare Strategy. This will tackle not just rare diseases, but it will be built on the foundations that the rare diseases community helped build with the 100,000 Genomes Project.

The National Genomic Healthcare Strategy will set out how the whole genomics community can work together to make the UK the global leader in genomic healthcare.

It is vitally important that this is not just a government exercise: we will be leading a national conversation and I want to encourage everyone with an interest – patient, carer or professional – to share their views and contribute to a coherent, national vision.

Conclusion

There is so much more I could say but I just want to close with this.

I know living with a rare disease or caring for someone for a rare disease can feel relentless. Unseen.

Please do not lost faith.

In the National Rare Diseases Policy Board, the Forum and in me as your minister, you have people advocating for you right at the heart of the system.

But we know we cannot do it without you. The mountains we have climbed were only conquered when we worked in true partnership – and there is still so much more to do.

That is why Rare Disease Day is all about you.

Thank you for your dedication, your expertise and your sacrifice.

And please – enjoy today, you’ve earned it.

In the draft Domestic Abuse Bill and consultation response published on 21 January 2019, government announced its intention to improve support for victims of domestic abuse who are going through family court proceedings.

The Ministry of Justice is pleased to announce that it has awarded a grant of just under £900,000 to two organisations who provide in-court support to vulnerable victims: the Personal Support Unit (PSU) and the Citizens Advice Witness Service.

PSU has been supporting litigants in person in family courts since 2001 and Citizens Advice has been supporting witnesses in criminal court proceedings since 2014. They both have extensive front-line experience of helping victims and witnesses navigate court processes and feel safe at court.

Citizens Advice will be using the funding to extend their current Witness Service to selected family courts to provide information and practical and emotional support to victims before, during and after the day of the hearing. PSU will be using the funding to invest in further training of their staff and volunteers and to share learnings on best practice with a range of family justice stakeholders.

The funding runs from January 2019 through to 31 March 2020, and will allow Citizens Advice to provide these services in up to 12 family courts across England and PSU in 24 courts across England and Wales.

We are determined to improve the experience of victims of domestic abuse in the family courts, and this grant is part of a wider package of measures across the family justice system. In the draft Domestic Abuse Bill we have committed to giving the family courts the power to stop unrepresented perpetrators of abuse from cross-examining their victims in person in family proceedings. We have also included a package of practical action in the accompanying domestic abuse consultation response.

Related link

Domestic abuse consultation response and draft bill

Latest update

The latest report by Public Health England (PHE) on seasonal levels of Group A streptococcal infection, published on Friday 10 May 2019, shows that 9,887 cases of scarlet fever have been reported since mid-September 2018, compared to an average of 14,128 for the same period over the last 5 years.

There were 247 cases reported for the most recent week (29 April to 5 May 2019).

Dr Theresa Lamagni, Senior Epidemiologist at Public Health England, said:

National levels of scarlet fever this season have remained relatively low compared to the past 5 seasons.

We continue to advise parents to look out for the symptoms such as a sore throat, fever and rash, and to contact their GP or NHS 111 if they spot symptoms or have concerns.

Scarlet fever, which mainly affects young children, is not usually a serious illness and can be easily treated with appropriate antibiotics.

Previous updates

Thursday 28 March 2019

The latest report by Public Health England (PHE) published at midday, Thursday 28 March 2019, shows that 7,854 cases of scarlet fever have been reported since mid-September 2018, compared to an average of 9,617 for the same period over the last 5 years.

There were 456 cases reported for the most recent week (18 to 24 March 2019).

Thursday 28 February 2019

The latest report by Public Health England (PHE) shows that 6,316 cases of scarlet fever have been reported since mid-September 2018, compared to an average of 6,680 for the same period over the last 5 years. There were 409 cases reported for the most recent week (18 to 24 February 2019).

Scarlet fever is usually a mild illness but it is highly infectious so PHE is advising parents to be on the lookout for symptoms, which include a sore throat, headache and fever with a characteristic fine, pinkish or red body rash with a sandpapery feel. If signs of scarlet fever are suspected, it is important to contact your local GP or NHS 111.

Early treatment with antibiotics is important as it helps reduce the risk of complications such as pneumonia and the spread of the infection to others. Children or adults diagnosed with scarlet fever are advised to stay at home until at least 24 hours after the start of antibiotic treatment to avoid spreading the infection to others.

Dr Theresa Lamagni, Senior Epidemiologist at Public Health England, said:

It’s not uncommon to see a rise in cases of scarlet fever at this time of year. Scarlet fever is contagious but not usually serious and can be treated with antibiotics to reduce the risk of complications and spread to others. We are monitoring the situation closely and remind parents to be aware of the symptoms of scarlet fever and to contact their GP for assessment if they think their child might have it.

PHE is investigating possible reasons for why there has been a rise in scarlet fever cases over the last few years by studying the strains of bacteria causing disease and the spread of infection in different settings and patient groups.

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said:

Patients with scarlet fever usually present with flu-like symptoms including a sore throat, fever and headache, as well as a characteristic rosy rash – usually on the patient’s chest initially.

Scarlet fever is a bacterial infection that generally affects children under 10 more than teenagers or adults. It is very contagious but can be quickly and effectively treated with a full course of antibiotics. GPs would also recommend patients to rest, drink plenty of fluids, and use antihistamine tablets or calamine lotion for relief of symptoms related to the rash.

We have seen more cases of scarlet fever in the last few years than we’ve been used to – we’re unsure why this is, but if a patient thinks that they, or their child, might have symptoms, then they should seek medical advice.

Background

For further information on scarlet fever visit the NHS website.

Guidelines for the management of scarlet fever are also available from PHE.